Recovery Rate and Predictors for Cure of Admitted COVID-19 Patients in Ethiopia; A Systemic Review and Meta-Analysis

Qeios Pub Date : 2024-05-16 DOI:10.32388/q79v3u

Fassikaw Kebede, Tsehay Kebede, B. Beletew, Atitegeb Abera Kidie

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Abstract

BACKGROUND. Despite the global efforts to curb COVID-19 infection using vaccines and drugs, the burden of illness, hospitalization, and death are continued as a deadly pandemic. Previous study finding estimated recovery time of 2 weeks for mild and 3 to 6 weeks for hospitalized cases. However, in low and middle-income countries like Ethiopia, recovery rate and viral negative conversion time are lowballed and underestimated due to the new variant incidence, limited resources and lacked skilled healthcare providers for admitted COVID-19 patients. This study aimed to estimate pooled recovery rate, and predictors for cure among admitted COVID-19 patients in Ethiopia. METHODS. Five electronic databases (Medline, PubMed, HINARY, Africa Journals Online, and Google Scholar) were searched. A total of 529 articles were extracted from cohort studies published in English spanning from December 30, 2019, to December 30, 2023. PRISMA guidelines were adhered to articles screening and extracted using Microsoft Excel. The quality of eligible articles was evaluated using the JBI checklist. The pooled effect size and adjusted odds ratio (AOR) with 95% confidence intervals were determined using the random-effect meta-regression using STATA version 17. Heterogeneity among studies was assessed using Cochran's Q-test, and the variation was estimated by I2, and presented in a forest plot. Subgroup analysis was also used to identify sources of heterogeneity among studies. RESULT. A total of 12 studies were included in the final meta-analysis. During the recovery screening of 5,152 admitted COVID-19 cases, 4,411 participants were discharged as cured. The pooled recovery rate was estimated at 90.6% (95% CI: 87.1-94.23, I² = 96.11%, P = 0.001). In subgroup analysis, Addis Ababa exhibited the highest recovery rate with 95.1%, followed by Oromia (94.6%), and Southern nation nationalities (SNN) region (91.55%). The recovery rate was higher for individuals aged 15-30 years (AHR = 2.01, 95% CI: 1.41-2.86, P = 0.001), males’ gender (AHR=1.46, 95% CI: 1.14-1.88, P=0.002), and cases admitted with ≥37.5°C (AHR = 2.01, 95% CI: 1.41-2.86, P = 0.001) compared to their counterparts. This manuscript is ongoing a submitted for registered in Prospero. CONCLUSION. In Ethiopia, nearly nine in every ten (90%) admitted COVID-19 cases recovered. However, the recovery rate exhibits a significant variation across each study region, setting, and pandemic phase. Therefore, healthcare providers prioritize care for critical cases to increase the overall survival rate of admitted patients.

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埃塞俄比亚 COVID-19 住院病人的治愈率和预测因素；系统回顾与 Meta 分析

背景。尽管全球都在努力使用疫苗和药物来遏制 COVID-19 的感染，但作为一种致命的大流行病，疾病、住院和死亡的负担仍在继续。以往的研究结果表明，轻度病例的恢复时间为 2 周，住院病例的恢复时间为 3-6 周。然而，在埃塞俄比亚等中低收入国家，由于新变异病毒的发病率高、资源有限以及缺乏熟练的医护人员来护理 COVID-19 患者，康复率和病毒阴转时间被压低或低估。本研究旨在估算埃塞俄比亚 COVID-19 住院患者的总治愈率和治愈预测因素。方法：检索了五个电子数据库（Medline、PubMed、HINARY、Africa Journals Online 和 Google Scholar）。从2019年12月30日至2023年12月30日期间用英语发表的队列研究中提取了529篇文章。文章筛选遵循PRISMA指南，并使用Microsoft Excel进行提取。符合条件的文章采用 JBI 检查表进行质量评估。使用 STATA 17 版本的随机效应元回归法确定了汇集效应大小和调整后的几率比（AOR）及 95% 的置信区间。使用 Cochran's Q 检验评估研究间的异质性，用 I2 估计差异，并以森林图显示。此外，还采用了亚组分析来确定研究间异质性的来源。共有 12 项研究被纳入最终的荟萃分析。在对5152例COVID-19入院病例进行康复筛查期间，有4411名参与者治愈出院。综合治愈率估计为 90.6%（95% CI：87.1-94.23，I² = 96.11%，P = 0.001）。在分组分析中，亚的斯亚贝巴的康复率最高，为 95.1%，其次是奥罗莫（94.6%）和南方民族（SNN）地区（91.55%）。与同龄人相比，年龄在 15-30 岁（AHR = 2.01，95% CI：1.41-2.86，P = 0.001）、性别为男性（AHR=1.46，95% CI：1.14-1.88，P=0.002）以及入院温度≥37.5°C 的病例（AHR = 2.01，95% CI：1.41-2.86，P = 0.001）的治愈率更高。本稿件已提交至 Prospero 注册。结论。在埃塞俄比亚，每 10 例 COVID-19 住院病例中就有近 9 例（90%）康复。然而，康复率在每个研究地区、环境和大流行阶段都存在显著差异。因此，医疗服务提供者应优先照顾危重病例，以提高入院患者的总体存活率。

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